This ADAMHA RSDA competing continuation application is requested to allow William H. Redd, Ph.D. to transfer his current fiver RSDA (with three years of funding remaining) from Sloan-Kettering Cancer Center to the Mt. Sinai Medical Center, where he will be appointed as a professor, July I, 1997. This application is an update of the proposal reviewed and funded in June 1994. NIMH regulations require re-review in order for a grantee to transfer a RSDA. significant number of bone marrow transplantation (BMT) survivors continue to experience psychosocial problems and occupational difficulties after completion of their cancer treatment Many of these symptoms are consistent with the characteristic symptoms of Post Traumatic Stress Disorder (PTSD), as defined by the American Psychiatric Association's most recent diagnostic manual DSM-IV, 1994). The proposed prospective longitudinal analysis seeks to examine PTSD/ PTSD symptomalogy, psychological distress, and quality of life in BMT survivors. The proposed research will also investigate the contribution of classical role of conditioning and information processing in post-treatment adjustment. BMT patients will participate in detailed psychosocial assessments: at baseline (time of medical preparation), daily during pre BMT, weekly during engraftment and recovery, and at 2-weeks post discharge and 6 & 12- months post-BMT. Specific aims are 1) to explore the longitudinal expression of PTSD symptomatology and psychological distress following BMT treatment; 2) to determine the role of demographic, illness, treatment and psychological variables in the development and severity of PTSD/PTSD symptomatology, psychological distress and off-treatment quality of life; 3) to assess how patients' physical and psychological reactions during the course of BMT treatment and their cognitive appraisals of the BMT treatment experience relate to the development of PTSD/PTSD symptomatology, psychological distress, and reduced quality of life; 4) to investigate ho psychosocial variables mediate and/or moderate the relation between patient baseline characteristics and symptomatology. proposed research will contribute to our understanding of PTSD and PTSD-like symptoms in survivors of treatment for life threatening illness. It should also help determine the validity and utility of the PTSD diagnosis in understanding adjustment difficulties in cancer survivors. It will advance efforts toward prevention of psychological morbidity by identifying those at risk for post-treatment distress so that appropriate interventions can be instituted.